{
  "abstract": "Background The CHA 2DS2-VASc score predicts poor prognosis in patients with acute myocardial infarction (AMI), with or without atrial fibrillation. In this observational study, we aimed to evaluate the CHA2DS2-VASc score by itself and extended with clinical data to predict adverse events in patients after AMI.Methods In this longitudinal observational study, we used a cohort of 955 patients hospitalised for AMI at Västmanland County Hospital, Västerås, Sweden, to derive prediction models. The CHA 2DS2-VASc score alone and combined with clinical data (systolic blood pressure, creatinine level, ST-segment elevation and diuretic use at discharge) was analysed using Cox regression to evaluate the risk of major adverse events (MAE), defined as all-cause death or hospitalisation due to recurrent MI, heart failure or ischaemic stroke. Discriminatory performance was presented as the time-dependent area under the curve (tdAUC). The prediction models were validated in 416 patients with AMI hospitalised at Uppsala University Hospital, Uppsala, Sweden.Results During a median of 2.5 years, 287 (30.1%) patients experienced MAE. CHA 2DS2-VASc scores of 2, 4 and 6 were associated with fourfold, ninefold and 18-fold increases in the relative risk of MAE, respectively, with a tdAUC of 0.76 at a 2-year follow-up. Extending the CHA2DS2-VASc score with clinical data significantly improved the prediction model (p<0.001), yielding a tdAUC of 0.81. The models performed well in the validation cohort, with satisfactory calibration and tdAUC values of 0.70–0.78.Conclusion The addition of clinical data to the CHA 2DS2-VASc score was superior to a model with CHA2DS2-VASc alone in predicting adverse events in patients after AMI, and the model performed well in external validation.",
  "authors": [
    {
      "affiliations": [
        "Department of Clinical Physiology, Västmanland County Hospital, Västerås, Sweden"
      ],
      "name": "Lina Carlsson"
    },
    {
      "affiliations": [
        "Centre for Clinical Research, Uppsala University, Västerås, Sweden"
      ],
      "name": "Jerzy Leppert"
    },
    {
      "affiliations": [
        "Department of Clinical Physiology, Västmanland County Hospital, Västerås, Sweden",
        "Centre for Clinical Research, Uppsala University, Västerås, Sweden"
      ],
      "name": "Jonas Selmeryd"
    },
    {
      "affiliations": [
        "Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden"
      ],
      "name": "Christina Christersson"
    },
    {
      "affiliations": [
        "Department of Clinical Physiology, Västmanland County Hospital, Västerås, Sweden",
        "Centre for Clinical Research, Uppsala University, Västerås, Sweden",
        "Department of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden"
      ],
      "name": "Pär Hedberg"
    }
  ],
  "title": "Prediction of adverse events after acute myocardial infarction: derivation and external validation of an extended CHA2DS2-VASc score model",
  "uid": "65d20665-5a08-5298-8fae-637b2b4ada4d"
}